Supported Decision-Making Service

Supported Decision-Making Service for Persons with Disabilities | Service Model

The Human Rights Center for People with Disabilitis

On a conservative estimate, supported decision-making services as an alternative for guardianship

can be relevant at least to a significant number of people among the 60,000 persons living under

guardianship in Israel. In fact, the number is much higher as it also includes persons without

guardianship who need assistance and support to realize their will.

Reference should also be made to a population which was not included in the pilot and which

is not the focus of this report – older adults: older adults living with dementia and their family

members who must often cope with the issue of their legal capacity and the need to have a

guardian appointed. It is very important to develop adaptive supported decision-making services

and additional alternatives to guardianship (such as a lasting power of attorney) for this population.

The Ministry of Justice Legal Aid Department and Yad Riva Association plan to conduct a

supported decision-making pilot for older adults.

to this report, which was written by

Prof. Israel (Issi) Doron, discusses the adaptation of the model proposed herein to older adults.

D. Description of the service

The supported decision-making service (hereinafter: the decision-making supporters or the

service) is based on a personal supporter assisting the person to realize his legal capacity by

promoting his wills and preferences. The supporter provides guidance, support and assistance in

making decisions in all areas of life and the support continues for as long as the person wishes

to receive it and needs it. The service includes practical training and guidance of the supporters.

E. Elements of the supporter role

The profile of persons who have been found suited for the role of supporter includes two

foundational elements, one formulated as a desired element and one as undesired:

1. A supporter need not be a care professional:

Most persons with disabilities have

many care professionals involved in their lives. The purpose of the support is to ensure

that the supporter does not represent the professional establishment but rather the

interests of the individual, from his or her perspective. It has been found that not only

was there no need to assign people with professional experience in providing care to

persons with disabilities to the role of supporter, but rather that it was advantageous

to assign people who are external to the professional establishment and do not bring a

care-based approach into their interactions with persons with disabilities. Consequently,

there is also no need to require any academic education as a minimum condition.

2. Relevant experience:

Any experience supporters have had in their personal

or professional lives that reinforces each of the following three elements in the

supporter's role has been identified as advantageous:

a. Worldview and values:

The worldview underlying the role of the supporter is that

every person has the right to make decisions about their life based on their wishes

and preferences. Consequently, it is imperative that supporters subscribe to this

worldview and believe in the supported person and their ability to make decisions

about their life. Supporters should be aware of the proclivity of professionals

working with persons with disabilities toward paternalism and over-protection.